Provider Demographics
NPI:1184655672
Name:CAMPILII-SNYDER PHYSICAL THERAPY PC
Entity Type:Organization
Organization Name:CAMPILII-SNYDER PHYSICAL THERAPY PC
Other - Org Name:CENTER FOR PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:CAMPILII
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:845-297-4789
Mailing Address - Street 1:2 DELAVERGNE AVE
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-1202
Mailing Address - Country:US
Mailing Address - Phone:845-297-4789
Mailing Address - Fax:845-297-8596
Practice Address - Street 1:2 DELAVERGNE AVE
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-1202
Practice Address - Country:US
Practice Address - Phone:845-297-4789
Practice Address - Fax:845-297-8596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY4C8920OtherHEALTHNET
NY0200701OtherAETNA
NYD788OtherCDPHP
NYQ1W511Medicare ID - Type UnspecifiedCMS MEDICARE